Dr. Jaiwant Rangi explains GLP-1 agonists like semaglutide (Ozempic, Wegovy) and tirzepatide (Mounjaro) for type-2 diabetes and weight loss. They work by increasing satiety and reducing appetite, producing 10-15% body weight loss over two years. These drugs cost $1,000-$1,300 monthly and often require insurance prior authorization.
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Hello everyone. We wanted to update you on a few things about the newer medications that have been talked about for weight loss. Since we get too many questions and a lot of you have asked me, even without being my patients, just as a curbside to, to know more about the drugs. So there's a class of medications called GLP1 agonists. These are the medications that are really making a lot of noise. The biggest and the most important one is Semaglutide. And Semaglutide comes under three different names, Ozempic, Rybelsus and Wegovy. Ozempic and Rybelsus are both prescribed for diabetes and Wegovy is prescribed just for weight loss. It's the same drug. Then we also have another drug called Mounjaro which is little more complex. It has two different peptides or two different medications that are in one and they, they make it a little bit different molecule compared to what you have at Semaglutide. So that causes little more robust weight loss. But that doesn't mean that holds true because there's no head to head trial to prove that comparison. However, in the studies it has shown a little bit more weight loss in the patients who were tested or tried on. So these class of medications, they do few different things. They make you feel fuller, faster, they make you feel less hungry, they also decrease the amount of glucose production from your liver, and they also make you release more insulin in proportion to the food that you're eating. So a lot of people need less and less diabetes medications and I've had a lot of patients whom I have taken off of insulin as well. So. So use the right way. These medications can be very helpful. However, who's the right candidate? Who should get it, who should not get it are the big questions. And once you start it, what all things you have to consider. So these are few questions that I normally get, so I'll answer them. And these pretty much hold good for all of those drugs that we just talked about. And I'll name those again. These are Ozempic, Rybulsis, Vigovy, Mounjaro, Trulicity, Orbitosa, Saxenda. These all belong to the same class of drugs. So can you take it if you're pregnant? Absolutely not. You should stop these medications two months before getting pregnant. Number two, is it the same thing as metformin? Absolutely not. Can you take it with metformin? Yes, you can. Can you take it with insulin? Yes, you can. But very likely you will need much less insulin. Insulin causes the basal decrease in Your blood sugars overall and Rybelsis and Ozempic, they help you control the postprandial or the blood sugar that rises after eating as well as the fasting. So they do two different things. So I have many, many patients that I have on long acting insulin and one of these medications simultaneously. But over time the end result is really good. Either I'm able to take them off of mealtime insulin completely or even, even lower the amount of long acting insulin and stop that completely. Other questions I get is regarding cost. Will my insurance cover? If my insurance doesn't cover, what's the cost? The drug is easily, I believe thousand to 1300 depending on what pharmacy you go to dollars per month. If you go cash only, I think some pharmacies can get you for eight to $900 per month. Will the insurance cover if you have true reasons to be on the medication? I do whatever it takes to help you get the medication covered. However, if you don't need to be on medication, sometimes insurances can be difficult. However, the insurances don't always work in your favor. So we have to fight it for a lot of you. We have to do prior authorizations or appeal or do things to make the drug work for you. So having said that, who's the right candidate? People who have diabetes. This class has been identified type 2 diabetes. This class has been identified as very important class of drugs and should be started earlier in the disease stage. So if somebody has diabetes at any stage, if it's type 2 diabetes, you should be given a trial of this medication. Except if you have a history of pancreatitis or if you've had intolerance to the medication or if you've had history of medullary thyroid cancer. What is the weight loss I can expect? The general weight loss you can expect is at least 10%, 10 to 15% of the body weight. However, the question is, will this last? It may not last if you stop it too soon. So in the studies these drugs were tested for at least two years. So that is a long time. It's a lot of cost to go on for that long. And that is why we offer lifestyle program in our practice for our patients who have diabetes so that we can help them naturally get all the knowledge of how to lose weight and how to have sustained weight loss. Sometimes we do bridge it with GLP1 agonist, but. But sometimes we don't. Depending on the patient's needs and requirements and requests. If they don't want to use any chemicals, we have the best program that we can offer. And we have had patients who have lost 10, 20, 30, £100 with our lifestyle program. So there are many options. There are a lot of things we can do. But yes, these drugs are making a lot of noise. If you have any questions, feel free to call our office. We have a webinar or educational seminar every Wednesday to talk about how you can achieve weight loss either naturally or with medications. And what are the pros and cons? And if you want consultation, we can do that as well. We look forward to seeing you. And if you have any questions, please feel free to call our office and we'll be able to help you. Thank you so much. Bye bye.
